[Congressional Record (Bound Edition), Volume 158 (2012), Part 1]
[House]
[Pages 1186-1190]
[From the U.S. Government Publishing Office, www.gpo.gov]




                             CONTRACEPTION

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 5, 2011, the gentlewoman from New York (Mrs. Lowey) will 
control the remainder of the hour.
  Mrs. LOWEY. Mr. Speaker, some decisions are just too important to be 
based on fear of political repercussions. That is why it is gratifying 
that President Obama heeded the advice of the Institute of Medicine and 
concluded that given its importance to women's health, contraception 
should be covered by health insurance as a free, preventative service 
for all American women.
  To accommodate religious institutions, the administration 
appropriately exempted places of worship from requirements to cover 
contraceptives in their health plans. The rule strikes a delicate 
balance respecting the rights of both religions ideologically opposed 
to birth control and American women.
  Let me be clear: No one will be required to use contraceptives. The 
rule simply allows women to exercise their own conscience when it comes 
to their health, and the vast majority of American women already do.
  It would be a grave mistake to make it more difficult to access 
medically recommended services for the 99 percent of all women who have 
used contraception in their lifetime.
  The administration was absolutely right to stand up for women's 
health by protecting access to contraception.
  I yield to Congresswoman Slaughter from New York.
  Ms. SLAUGHTER. I thank the gentlelady for yielding.
  Mr. Speaker, I want to commend President Obama and Health and Human 
Secretary Sebelius for including contraception as a preventive service 
that health insurance plans are required to cover at no cost.
  This decision, based on the recommendation of the Institute of 
Medicine, is the right decision for women. It affirms the individual 
freedom of women to make choices about their health and their future.
  Following the administration's decision, there has been an uproar 
from the religious community. While some claim it is in violation of 
First Amendment rights, the simple truth is that this decision upholds 
the First Amendment rights of millions of women to not have their 
reproductive health managed by religiously affiliated organizations who 
may not share their own beliefs.
  This decision stands up for women's freedom, as it is a woman's right 
to decide when and how she wants to have a family, whether or not she 
chooses to use birth control, as 98 percent of Catholics do. If she 
subscribes to a religion that teaches against the use of birth control, 
then she is free to choose not to use it either.
  If she would rather use birth control for the many health protections 
and benefits that it provides, such as the fibroid tumors, migraine 
headaches, and bleeding that cannot be controlled, she should also be 
free to do so. Either way, the choice should belong to her and to her 
alone.
  It is also important to note the details of the administration's 
decision.
  We're not talking about churches or organizations that exist for the 
sole purpose of teaching their religion.

                              {time}  1750

  These organizations are totally exempt from providing coverage for 
contraception.
  What we are talking about is religiously affiliated organizations, 
such as hospitals, schools and universities. Millions of women are 
employed by these types of organizations, and those women do not 
necessarily share the beliefs of their employers. In fact, I think one 
of the most egregious things felt by many women is that whatever their 
own religions teach, they are not going to be allowed to go by that.
  Catholic hospitals can and do--and we want them to--employ Baptists, 
Methodists, Protestants, Muslims, Jews, Buddhists, agnostics, and 
atheists. Teachers, cafeteria workers, administrative staff members at 
religious schools and universities are not necessarily members of that 
religion. Those employers should not have the right to decide whether 
or not the women on their insurance plans can access birth control. 
They still have separation of church and state.
  Many religions that teach against the use of birth control also teach 
against divorce, but institutions affiliated with those religions are 
not allowed to discriminate against employees based on their marital 
status. They do not have an exemption from labor laws because of their 
religious beliefs. This is no different.
  A recent decision by the administration shows that they are standing 
with women and supporting their freedom to make the choices that impact 
themselves and their families. Surveys have repeatedly shown that women 
and men across this country support providing access to contraception 
at no cost and that that support is equally strong among members of the 
very religious who are fighting this decision.

[[Page 1187]]

  I applaud the President and Secretary Sebelius for supporting the 
health and freedom of women, and I support their decision to put 
women's personal health and freedom first.
  I yield to the gentleman from Illinois.
  Mr. QUIGLEY. Mr. Speaker, when it comes to religious exemptions, a 
balance must be struck. The rights of religious followers must be 
protected while also respecting the beliefs of others who may be 
impacted by a religious exemption.
  Take, for example, a Catholic university where Jews, Hindus, Muslims, 
and non-religious followers work. Should these individuals be denied 
access to contraception even though their faiths do not oppose it?
  If we expand the religious exemption too far and allow religiously 
affiliated institutions to deny contraception to their employees 
regardless of their religious beliefs, we begin to see the beliefs and 
rights of those who support and require contraception infringed upon.
  As policymakers, we have to stand up for the rights of all of our 
constituents regardless of their faiths. This means making policies 
that walk the line between protecting the rights of primarily religious 
institutions while also protecting the rights of individuals employed 
by religiously affiliated institutions. The administration's exemption 
strikes that balance.
  I yield to the gentlewoman from California.
  Mrs. DAVIS of California. Mr. Speaker, I rise to applaud the final 
ruling issued by the Department of Health and Human Services to include 
birth control at no cost.
  The pill changed the world. As some have said, it was one small pill, 
but one giant leap for womankind. It improved women's health. It 
reduced infant mortality. It increased a woman's earning potential. It 
empowered families to chart their own courses. Yet, currently, one in 
three American women struggles to afford birth control. A woman's right 
to decide when to start a family is meaningless if she does not have 
the means to make a choice. All of these benefits could be denied 
because of a relatively small amount of money, and that is simply 
unacceptable.
  I am pleased that we are living up to the promises made in the 
Affordable Care Act, and I urge my colleagues to join me in protecting 
and increasing access to health care for every woman in America.
  I yield to the gentlewoman from New York.
  Mrs. MALONEY. Thank you.
  I rise in support of the President's action and Secretary Sebelius' 
action in the Department of Health and Human Services to allow the 
birth control benefit for working women across this country.
  This birth control benefit increases access to preventative health 
care while respecting religious freedom. This is accepted practice in 
28 States--28 States that require insurers that cover prescription 
drugs to provide coverage of the full range of FDA-approved 
contraception drugs.
  Taking this benefit away would be devastating for millions of 
workers. Women's access to care is absolutely on the line, and they 
have turned it into a religious versus reproductive freedom debate. 
Birth control is medication prescribed for women's health, plain and 
simple. It is not radical. As I said, 28 States already supply it, and 
roughly 99 percent of women use birth control at some point in their 
lives; but the only way they can use it is if they can get it, so the 
right to choose is absolutely meaningless without the means and access 
to choice.
  The President's thoughtful decision allows insurance companies to 
cover contraceptives. It does not in any way interfere with one's 
religious beliefs or the beliefs of the church. It does not force 
anyone to use them, and it certainly does not require anyone--churches 
or anyone else--to cover them. Yet, if it is a university, if it is a 
major employer that is employing many people and not people of one 
faith but of many different faiths, then it is required to follow the 
law of this country.
  So let's end this assault on women's health, and let's listen to the 
millions of Americans who rely on birth control each and every day. 
It's important for their health, and I applaud the President and 
Secretary Sebelius.
  I yield to the great Congresswoman from the great State of 
California.
  Ms. LEE of California. I want to thank the gentlelady for yielding 
and also for standing up for women's health, not only today and during 
these very difficult times, but each and every day of her life.
  As a former devout practicing Catholic, I fully understand and 
respect the Church's doctrine on contraceptives. Even though I disagree 
with it, I fully respect it and I understand it. Also, I know that the 
separation of church and state is a fundamental principle that we must 
maintain.
  Mr. Speaker, the administration's decision to provide choices to 
access quality, affordable health care, family planning services, 
including contraceptives, are vital for women's health and well-being. 
This is really not about a mandate. The rule would not force anyone 
with a religious objection to use or prescribe FDA-approved 
contraception. The fact is that Catholic bishops know that the 335,000 
religious institutions and organizations and churches and places of 
worship are exempt. In fact, no woman will be required to use 
contraceptives or to even access contraceptives if she does not want to 
do that. This ruling is about women making their own decisions as to 
whether to use contraceptives or not. It's about access.
  Religion must not force discrimination and discriminatory policies 
against, for example, an employee who works in the cafeteria of a 
hospital who chooses to plan her family. She should not be denied this 
coverage because of where she works. Low-income women finally--
finally--will have equal access to contraceptive services if they 
choose.
  So we want to make sure tonight that the facts are presented 
appropriately. Yes, we've witnessed this war against women 
systematically come against women's health for the last year now, and 
it's about time we start really being truthful to the public and get 
the facts out there and not allow the misinformation to really put 
women, once again, in a position of not having access to contraceptive 
care.

                              {time}  1800

  So I believe that this decision was right. I know that it allows for 
religious exemptions. And this rule should now allow for employees, for 
nurses, for health care workers to access contraception when they want 
to, and if they choose not to. They don't have to. But we should not 
allow discrimination to take place anymore.
  I yield now to the gentlelady from California, Congresswoman Lois 
Capps.
  Mrs. CAPPS. I thank my colleague, Barbara Lee from California, for 
yielding to me. And I also want to thank our colleague from New York, 
Nita Lowey, for her leadership in organizing this opportunity for us to 
speak, to speak with one voice, we who are Members of Congress, women 
Members of Congress. And speaking for myself, some of us are mothers, 
are grandmothers. And my career in public health greatly informs what 
I'm about to say.
  Mr. Speaker, I rise today in support of the Obama administration's 
decision to include contraception in their very, very important list of 
preventive services which will make women's health care more 
affordable. Let us be clear: This was not a political decision on the 
part of the administration, on the part of our President, nor was it 
intended to attack any religious institution. It was a decision based 
on extensive science and the expert recommendations made by these 
scientists with the goal in mind of keeping women and their children 
healthy.
  However, a great deal of misinformation has been spread about this 
rule, and some have decided to, again, use women's health as a 
political football. But the truth is that this issue is not as divisive 
as many would like it to be. Almost all women use a form of an FDA-
approved birth control at one point or another in their lifetime. This

[[Page 1188]]

includes 98 percent of Catholic women as well. And most Americans, men 
and women, believe that women--not their bosses--that women should have 
the choice of which health care services they can and want to access.
  But, you know, some would have us believe that the administration's 
rule is in some way radical. It is not. Twenty-eight States already 
require the coverage of contraception in their insurance plans, and the 
new Federal standard is based on the one that has worked in my home 
State of California for many years. It has done so without any 
religious hospitals dropping coverage or firing employees. It's worked 
perfectly well. The administration now has made the right call, and I 
speak on behalf of women in this country urging the administration to 
stay the course.
  Now it is my honor and pleasure to yield to our colleague from 
Maryland, Donna Edwards, a very appropriate person to speak on this 
topic.
  Ms. EDWARDS. I thank the gentlelady for yielding.
  Mr. Speaker, I just want to express my support for the 
administration's ruling that provides women and families across this 
country, no matter their faith, the opportunity to take control of 
their own reproductive health and to gain access to contraceptive 
services.
  The opposition we are hearing--although very vocal, from very few 
voices--does not adequately reflect the voices of the millions of women 
across this country who rely on contraception.
  Mr. Speaker, 99 percent of women in the United States and 98 percent 
of Catholic women already use birth control; and it's estimated that, 
on average, women use birth control for 30 years. Polls conducted 
across the country over the last week also have found that more than 
half of the United States population believes that employers should 
provide health care plans that cover contraception and birth control at 
no cost.
  Unfortunately, over the last week, since the administration's ruling, 
I believe religious leaders have misinterpreted and misled the American 
people on the rule's implications. The exemption in the ruling actually 
very carefully protects the rights of churches and church associations. 
The administration justly limits the exemption of institutions whose 
main purpose is for spreading religion and employ and serve people of 
the same faith. Clearly, the opposition doesn't express this. Extending 
this exemption beyond these churches to other religious institutions 
would directly undermine the intent of the health care reform law for 
the more than 640,000 individuals employed, in particular, by Catholic 
hospitals.
  And let's be clear: Contrary to what some have said, this ruling has 
absolutely nothing to do with abortion. In fact, the ruling will save 
women up to $600 per year and keep their employers from absorbing a 15 
to 17 percent increase in health care costs simply not to provide women 
with contraceptive coverage.
  Women and families across the country deserve the option to receive 
comprehensive contraception coverage if they desire. The rule doesn't 
prescribe contraception to women. If a woman chooses to exercise her 
faith and not use contraception, she's free to do so under this ruling. 
However, limiting access to contraception to any subset of the 
population would be a direct affront to the scientific and medical 
recommendations of the Institute of Medicine.
  Catholic institutions are in an untenable position. After all, where 
is it that we would draw the line? Should those institutions exercise 
their role as employers rather than their role in their faith 
tradition? I would argue that of course this is about their role as an 
employer.
  What, for example, would the government do if these institutions also 
believed that they should exempt themselves from paying payroll taxes 
because they believe that under their faith tradition people's 
responsibility is to tithe instead? Would we allow them to self-exempt 
from payroll taxes? I don't think so.
  Contraception and maternal health is all a part of a woman's 
comprehensive health care, just like breast exams, screenings, and 
well-woman visits. Fifty percent of pregnancies in this country are 
unplanned, and it's widely understood that these unplanned pregnancies 
are not as healthy as planned pregnancies. This can cost taxpayers up 
to $11 billion a year. And at a time when the other side is slashing 
budgets and proposing reforms to shift costs to States, this ruling is 
about as smart as we get for our health care system, for women and 
families, for babies, and for American taxpayers.
  Making certain women and families have the opportunity to plan 
pregnancy is critical for our society. The administration's ruling 
protects women, families, and babies, eliminates discrimination of one 
group of women over another, and it's important for us. The ruling 
respects the religious beliefs and freedoms of all Americans and health 
care providers while it ensures that women have the full option to 
pursue contraception.
  I stand with my colleagues in support of the administration's rule 
and look forward to working to expand health care coverage and women's 
health care coverage.
  At this time, I would like to yield to my colleague from Connecticut, 
the Honorable Rosa DeLauro, who is a true leader for women's health 
care, and I appreciate her leadership.
  Ms. DeLAURO. As both a Catholic and an advocate of women's health, I 
believe that these guidelines strike the necessary balance between 
increasing access to health care services for women while respecting 
the religious beliefs of all Americans.
  These guidelines are based on recommendations from the Institute of 
Medicine, a nonprofit, independent organization that is grounded and 
rooted in science. They have recommended that women have access to a 
wide range of services, such as screening and counseling for domestic 
violence, that pregnant women have access to services such as a 
screening for gestational diabetes, that women have access to at least 
one well-woman preventive care visit a year, and that all women have 
access to a range of contraceptive services, counseling, and methods.
  Let me be clear: The Catholic Church and its employees are exempt 
from these guidelines. They apply only to church institutions that 
serve the larger community, employ people of different faiths on a 
nonreligious basis, and do not meet the clear requirements for a 
religious exemption. There are thousands of non-Catholics who work in 
Catholic hospitals and in Catholic universities.
  Improved access to birth control is directly linked to declines in 
maternal and infant mortality and helps to reduce unintended 
pregnancies.

                              {time}  1810

  That is why 28 States, including Connecticut, already mandate the 
coverage of contraceptive service and why many private employers 
already cover these services.
  I'm proud to support what I believe to be a moral decision by the 
administration and a well-drafted compromise that maintains the 
existing Federal conscience protections and at the same time allows 
women access to contraceptive service and other preventive health care 
services without mandating in terms of contraceptive services that one 
use it or be required to dispense it.
  I would like now to yield to my colleague from Washington, DC, the 
Honorable Eleanor Holmes Norton.
  Ms. NORTON. I thank the gentlelady for yielding. And I think, Mr. 
Speaker, in the next several days and weeks you're going to see people 
come forward to speak up for the silent majority in this controversy 
about contraception and what institutions should and should not 
provide. Whoever has been a silent majority, today it is the women of 
America, particularly women who may happen to work for Catholic 
hospitals, for a Catholic university as I did, for example, when as a 
Protestant I worked as a tenured professor of law at Georgetown 
University here in Washington, DC.
  The Catholic Church has long accepted the laws against discrimination 
except as to the Church itself and the

[[Page 1189]]

Church's own activities. And so you'll find in a Catholic hospital or 
Catholic university you must hire people regardless of their race or 
religion and the like.
  Now, the Church seems to be seeking a different rule on how you 
accommodate religion. We have accommodated the Catholic Church when it 
comes to hiring its own employees, for example. And the administration 
has accommodated the Catholic Church when it comes to the provision of 
contraceptives for its own church employees.
  However, there are hundreds of thousands of women and men who work 
for hospitals, for universities, and other institutions that hold 
themselves out as nondiscriminatory and as accepting all people. For 
that reason the Church, of course, qualifies for Federal funds because 
it is accepted, as acting as a public institution in the place of a 
public institution.
  We have a long and treasured history, Mr. Speaker, of religious 
accommodation. When I chaired the Equal Employment Opportunity 
Commission, I recall the many cases in which we tried to err on the 
side of religious accommodation, but the accommodation must never be so 
broad as to trample on the rights of others. To accommodate the 
institution and not accommodate the people whose conscience is being 
trampled, of course, is precisely what the Constitution does not allow.
  A broad accommodation to the Church that would relieve it of offering 
a health care service that is essential would penalize the rights of 
thousands of non-Catholics. So whatever the right of the Church is, it 
does not have the right to trample on the rights of others. That's how 
accommodation works.
  The administration's own exemption is patterned on identical 
religious exemptions that have been tested in the courts and found to 
be constitutional.
  I think the administration was looking at two things when it 
fashioned a very, very generous exemption for the Church in the health 
care law. First, it was looking for what was necessary to do as vital 
to the health care of women, but it was also looking to what was 
constitutional.
  Mr. Speaker, if I may say so, I believe the broad exemption which the 
Catholic Church seeks which would penalize the rights of thousands of 
women who work for catholic-affiliated institutions who are not 
Catholic who do not share their views, whether or not they are 
Catholic, on this issue, if such an exemption were to be granted, then 
the administration, it seems to me, would find itself engaging in an 
unconstitutional exemption.
  The administration has accommodated the Church. It has fulfilled its 
obligation to see to it that women have a vital health care service, 
and it has prevented an unconstitutional violation.
  I am pleased to yield now to the gentleman from New York.
  Mr. NADLER. I thank the gentlelady for yielding, and I thank her for 
her excellent exposition as to the law and the constitutionality, with 
which I am in full agreement.
  As we all know, the administration recently announced that a popular 
and critically important component of the health care reform law would 
guarantee that most women have access to contraceptives paid for by 
their health insurance. This decision was based on the sound science of 
the impartial and independent Institute of Medicine, which recognized 
that contraceptives are an essential health service fundamental to 
improving the lives of women and their families.
  This decision is a major victory for women. Eighty-nine percent of 
American women, including a similar percentage of Catholic women, use 
contraceptives at some point in their lives. Particularly at this time 
of economic uncertainty, women will have one less cost to worry about 
that can be a substantial cost. Make no mistake about it, freeing up 
$600 or $800 a year will have significant effects on working families.
  The decision also recognizes and supports religious freedom by 
providing certain limited exemptions for places of worship, as well as 
for those organization that hire and predominantly care for those who 
share the same religious beliefs. They were protected against being 
required to violate their religious teachings.
  I am proud to stand shoulder to shoulder with President Obama and his 
administration for helping to strike this important balance between 
religious rights and the rights of women to protect their health.
  Yet to hear some people talk about this decision, you'd have no idea 
that the religious organizations and the religiously devout have their 
liberties protected. Amid all the hyperbole, the truth is that the 
administration's decision, while significant and important, is hardly 
new. This measured approach that balances religious rights on the one 
hand and the rights of women on the other is already the standard in 28 
States, including my home State of New York.
  Because it is not just employers and corporations that have rights at 
stake, hardworking people and their families also have rights.
  Under the approach adopted by the administration, universities and 
hospitals which serve and employ people from a multitude of faiths and 
cultures are not exempt from the requirement that health insurance 
provide coverage for contraceptives, nor should they be. Women should 
not be denied a basic health service merely because they work or study 
at a university or hospital affiliated with a religious organization.
  The difference here is that churches are and should be protected in 
their religious role, protected against having to violate their 
religious views, but they must not be protected in their role as 
employers. We permit a church, for example, to discriminate in 
religious practice. No one asks the Catholic Church how come you do not 
permit women priests? That's their business.
  But we do not permit them to discriminate as employers. We do not 
permit a church-affiliated hospital or university to say we will not 
permit the hiring of female doctors or female professors or black 
doctors or nurses because that would impinge on liberty. If a church 
has a doctrine against hiring female priests, that's fine. But hiring 
female professors in the university, unless it was a solely 
ecclesiastical university, only for religious purposes, if it is a 
regular university, then they cannot be permitted to have that kind of 
discrimination.
  We protect religious liberty, but we cannot permit a church to impose 
its views on others who may not share those views.

                              {time}  1820

  The church can preach its views, it can seek to persuade people, but 
it cannot coerce people who may work for a church-affiliated university 
or hospital that they cannot use contraceptives if they want to. The 
liberty here is the liberty of the employee that must be protected. The 
liberty of the church must be protected in its churchly function and in 
its function as a religious institution. In its function as an 
employer, the liberty belongs to the employees. And that is the 
distinction that is made here. It is the proper distinction.
  Imagine if some other church that thinks that it is wrong to give 
transfusions to people, blood transfusions, ran a hospital. We would 
not permit them to let people die in that hospital for lack of 
transfusions because it's not up to them to decide medical practice by 
their religious doctrine. If the person wants to refuse treatment 
because his religious doctrine says, I don't want a transfusion, that's 
his liberty. But we must not confuse the religious liberty of the 
church to propagate its views and to conduct its religious affairs as 
it sees fit with the liberty of employees in a secular institution 
affiliated with the church to have the normal protections against 
discrimination and the normal rights that we afford all people.
  That is why the administration's decision to say that contraceptives 
are scientifically a necessary health care service which must be 
provided by health insurance is right, and any attempt by a religious 
institution to say that they should be exempt from having employees 
allowed to get contraceptives paid for is wrong, and I applaud the 
administration for making

[[Page 1190]]

the proper distinction to protect the liberty of the employees and the 
religious liberty of the church both.
  I yield to the distinguished gentleman from New Jersey.
  Mr. HOLT. I thank my friend from New York.
  This is an important subject. As previous speakers have made clear, 
birth control is fundamental to women's health, just like cholesterol 
testing and any number of other things. And decades of evidence show 
that planned births produce healthier babies and healthier mothers. 
Anyone who is working as a health care aide or a nurse or working in a 
religiously affiliated social service agency would want health care 
provided to them that is not discriminatory, and that includes the 
range of services that provide for good health.
  Purely religious organizations would be, are, have been and will be 
exempt. But when an institution, even if affiliated with religion, 
chooses to provide public services and accept public money, they must 
follow public fair employment practices and not discriminate in hiring 
or salary or benefits. And now, under the Affordable Care Act, they 
also may not discriminate against women and women's services in 
providing health care benefits.
  That's what we're talking about here. It's really quite 
straightforward. Expanding the religious exemption to religious 
institutions that employ people of all faiths would take preventive 
services away from millions of Americans, would result in substandard 
health care for far too many women in our country, and it would allow 
religious institutions to be able to discriminate against employees of 
different faiths.
  It's only fair. It's only what has become recognized by the courts, 
by the public, and by general public mores as the right thing to do. 
And now under the health care act, it would be institutionalized for 
all agencies except purely religious agencies that hire only in one 
faith.
  So, Mr. Speaker, I think there's been a lot of misinformation about 
this. I hope tonight's discussion has helped to clarify the matter.
  With that, I am pleased to yield back to my friend from New York.
  Mrs. LOWEY. I thank my colleague from New Jersey.
  In conclusion, I want to emphasize, again, that the Institute of 
Medicine found that contraceptives save lives. There are numerous 
studies that have shown that contraceptives lower the risk of 
developing ovarian cancer, help prevent unintended pregnancies, improve 
outcomes for children, and reduce abortions. So, my friends, it's hard 
to believe that in the year 2012, we are having a debate about whether 
or not insurance plans should cover contraceptives.
  Let's remember that for many women in this country, of the 98 percent 
of women that are using contraception at some point in their lives, 
let's remember that for many women, $1,000 a year is money that they 
can't afford. So let's support the administrative position recommended 
by the Institute of Medicine.
  Mr. Speaker, I yield back the balance of my time.

                          ____________________